<%@ page language="java" contentType="text/html; charset=UTF-8"
	pageEncoding="UTF-8"%>
<%@ include file="include.jsp"%>
<!DOCTYPE html>
<html lang="en">
<head>
<%@ include file="head.jsp"%>
<title>Register</title>
</head>

<body>
	<div class="container">
		<%@ include file="header.jsp"%>
		<div class="row">

			<div class="span12">
				<h1>Create an account</h1>

				<br />
				<form class="form-horizontal">
					<fieldset>
						<div class="span6 no_margin_left">
							<legend>Your Personal Details</legend>
							<div class="control-group">
								<label class="control-label">First Name</label>
								<div class="controls docs-input-sizes">
									<input type="text" placeholder="" class="span4">
								</div>
							</div>
							<div class="control-group">
								<label class="control-label">Last Name</label>
								<div class="controls docs-input-sizes">
									<input type="text" placeholder="" class="span4">
								</div>
							</div>
							<div class="control-group">
								<label class="control-label">Email Address</label>
								<div class="controls docs-input-sizes">
									<input type="text" placeholder="" class="span4">
								</div>
							</div>

							<div class="control-group">
								<label class="control-label">Telephone</label>
								<div class="controls docs-input-sizes">
									<input type="text" placeholder="" class="span4">
								</div>
							</div>
						</div>
						<div class="span6">
							<legend>Your Address </legend>
							<div class="control-group">
								<label class="control-label">Address 1</label>
								<div class="controls docs-input-sizes">
									<input type="text" placeholder="" class="span4">
								</div>
							</div>
							<div class="control-group">
								<label class="control-label">Address 2</label>
								<div class="controls docs-input-sizes">
									<input type="text" placeholder="" class="span4">
								</div>
							</div>
							<div class="control-group">
								<label class="control-label">City</label>
								<div class="controls docs-input-sizes">
									<input type="text" placeholder="" class="span4">
								</div>
							</div>
							<div class="control-group">
								<label class="control-label">ZIP</label>
								<div class="controls docs-input-sizes">
									<input type="text" placeholder="" class="span4">
								</div>
							</div>
							<div class="control-group">
								<label class="control-label">Country</label>
								<div class="controls docs-input-sizes">
									<input type="text" placeholder="" class="span4">
								</div>
							</div>
						</div>

						<div class="span12 no_margin_left">
							<legend>Your login </legend>
							<div class="span6 no_margin_left">
								<div class="control-group">
									<label class="control-label">Username</label>
									<div class="controls docs-input-sizes">
										<input type="text" placeholder="" class="span4">
									</div>
								</div>
							</div>
							<div class="span6">
								<div class="control-group">
									<label class="control-label">Password</label>
									<div class="controls docs-input-sizes">
										<input type="text" placeholder="" class="span4">
									</div>
								</div>
								<div class="control-group">
									<label class="control-label">Confirm password</label>
									<div class="controls docs-input-sizes">
										<input type="text" placeholder="" class="span4">
									</div>
								</div>
							</div>





						</div>


						<div class=" span12 no_margin_left">
							<hr>
							<div class="span8">
								<input type="checkbox" value="option1"
									name="optionsCheckboxList1"> I have read and agree to
								the Privacy Policy<br /> <input type="checkbox" value="option2"
									name="optionsCheckboxList2"> Subscribe to our
								newsletter

							</div>
							<div class="span3">
								<button class="btn btn-primary btn-large pull-right"
									type="submit">Register</button>
							</div>
							<hr>
						</div>
					</fieldset>
				</form>

			</div>
		</div>
		<%@ include file="footer.jsp"%>
	</div>
</body>
</html>